Consequences Of Interventions Research Articles

A CONCEPTUAL FRAMEWORK TO ANALYSE CONSEQUENCES OF POST-CONFLICT RECONSTRUCTION INTERVENTIONS

This study examines the intricate dynamics of post-conflict reconstruction (PCR) to develop a conceptual framework for analysing the various consequences of interventions in this complicated field. The study employs a mixed-methods strategy combining a comprehensive literature assessment and conceptual analysis. The literature review explores multiple theoretical frameworks on PCR, including perspectives from political economics, development studies, and peacebuilding. Using the conceptual analysis approach, establishing a comprehensive framework is the outcome of a methodical investigation into the interaction between context, intervention, and outcomes in PCR. The paradigm is then utilized to analyse case studies of Rwanda, the Central African Republic, and The Gambia, offering practical observations and empirical evidence. The findings demonstrate that PCR treatments yield diverse outcomes, encompassing both intended and unanticipated consequences. The study highlights the crucial significance of contextual elements, such as the participation of global entities, power dynamics, and historical legacies, in determining the effectiveness of interventions. The study determines that PCR is a complex and detailed process requiring a comprehensive understanding of the interaction between environment, intervention, and outcomes. The suggested conceptual framework offers a valuable tool for assessing the complex effects of PCR initiatives, allowing policymakers, practitioners, and scholars to create and execute more efficient and contextually appropriate interventions. The research highlights the importance of continuous efforts to advance evidence-based strategies that foster lasting peace and fair development in societies recovering from war. This helps to bridge the gap between theory and practical implementation.

The effect of intentional summer flooding for mosquito control on the nitrogen dynamics of impounded Avicennia germinans mangrove forests

Coastal wetlands such as mangrove forests are breeding grounds for nuisance-causing insects. Rotational Impoundment Management (RIM) for mosquito control involves annual summer inundation of impounded mangrove forests with estuarine water during the summer half year. However, in addition to controlling mosquitos, RIM may change biogeochemical pathways. This study set out to investigate how RIM quantitatively affects physicochemical soil characteristics and potential nitrifying and denitrifying activities (PNA and PDA), which are key in the global nitrogen cycle. Before and after the implementation of RIM, soil samples were collected annually in habitats differing in size and abundance of black mangroves (Avicennia germinans) in an impoundment with RIM and in an adjacent impoundment with a more open connection to the lagoon. Compared to the non-managed impoundment, soil moisture content, total nitrogen and PDA increased, while salinity decreased after the start of annual summer flooding, but only in the dwarf habitat. In the sparse and dense habitats, total nitrogen and PDA increased independently of summer flooding, whereas soil moisture content and salinity were not affected by RIM. Labile organic nitrogen increased only in the RIM impoundment, irrespective of the habitat type. PNA was generally not affected with time, except in the dwarf habitat in the absence of intentional summer flooding where it increased. Changes in the non-managed impoundment adjacent to the RIM impoundment demonstrate the importance of groundwater exchange in linked ecosystems. The consequences of interventions in the management of mangrove impoundments and adjacent forests for the nitrogen budget are discussed.

The Lived Experience of Racism in the Sikh Community.

The Sikh community may be more visible and vulnerable to racism than other religious groups, and previous research has documented the racism targeted at Sikh men and women in the United States. Relatively few studies have, however, addressed the racism experienced by Sikh communities in other countries, where racism may be less closely connected to the events of 9/11. The present study investigates the lived experience of racism in Sikh adults living in the United Kingdom. Six participants (5 male, 1 female) aged 19 to 30 years (M = 24.17, SD = 3.98) were recruited via advertisements placed on social media. Both Amritdhari Sikhs (n = 4) who had undertaken the Amrit Sanskar initiation ceremony or commitment and Sahajdhari Sikhs (n = 2) who had not undertaken the initiation participated. Semi-structured interviews were conducted (totaling 372 minutes of interview data), covering a range of subjects including personal experiences of racism and subsequent responses to the racist abuse. Interpretative Phenomenological Analysis of the interview transcripts identified five superordinate themes. These were (1) Appearance and Visibility; (2) Inevitability and Normalization; (3) Coping and Conformity (Religion as Support, Fitting In, Internalization); (4) Education and Understanding; and (5) Bystander Behavior (Experiences of Intervention, Religious Duty to Intervene, Consequences of Intervention). Findings highlight the extent to which racism occurs and the increased vulnerability of the Sikh community (e.g., appearance being the focus of racist abuse). Findings also highlight the importance of religion as a source of support and cultural pride and the significance of education and bystander behavior. Future research should further investigate these themes and introduce interventions to support the safety and well-being of members of the Sikh community experiencing racist abuse.

Dilemmas of anthropological activism, solidarity, and human rights: Lessons from Haiti

AbstractBuilding on a growing anthropological engagement with and interrogation of the multiple forms and meanings of activism, this article—based on over 20 years of activist engagement and ethnographic interviews spanning 11 years—offers ethnographically grounded understandings of solidarity activism. The rich and at times messy (auto)ethnographic data suggest that contradictions inherent to liberal humanism can increase hierarchies and social distance between groups across national boundaries. Further, new social media technologies notwithstanding, nongovernmental organizations (NGOs) remain hegemonic vehicles for this transnational exchange. The experience in Haiti, dubbed the “Republic of NGOs,” highlights contradictions within solidarity activism, generating a useful set of questions for other activist anthropologists and solidarity activists who work elsewhere. Moving beyond the discussion of what anthropology brings to activism, or the reverse, this article offers insights from ethnographic analyses of NGOs, or NGOgraphy, to critically understand and assess anthropological activism. Specifically, building off insights of “NGOing” as a verb, this article interrogates the (micro)politics, structures, and consequences of intervention. Further, international solidarity activism often operates on logics of projects and deliverables, and therefore NGOing can eclipse other “metrics,” disrupting and dividing local communities. Like NGOs, anthropologists function within a hierarchical transnational political economy and division of labor. [activist anthropology, Haiti, NGOs, solidarity, autoethnography]

Navigating power in conservation

AbstractConservation research and practice are increasingly engaging with people and drawing on social sciences to improve environmental governance. In doing so, conservation engages with power in many ways, often implicitly. Conservation scientists and practitioners exercise power when dealing with species, people and the environment, and increasingly they are trying to address power relations to ensure effective conservation outcomes (guiding decision‐making, understanding conflict, ensuring just policy and management outcomes). However, engagement with power in conservation is often limited or misguided. To address challenges associated with power in conservation, we introduce the four dominant approaches to analyzing power to conservation scientists and practitioners who are less familiar with social theories of power. These include actor‐centered, institutional, structural, and, discursive/governmental power. To complement these more common framings of power, we also discuss further approaches, notably non‐human and Indigenous perspectives. We illustrate how power operates at different scales and in different contexts, and provide six guiding principles for better consideration of power in conservation research and practice. These include: (1) considering scales and spaces in decision‐making, (2) clarifying underlying values and assumptions of actions, (3) recognizing conflicts as manifestations of power dynamics, (4) analyzing who wins and loses in conservation, (5) accounting for power relations in participatory schemes, and, (6) assessing the right to intervene and the consequences of interventions. We hope that a deeper engagement with social theories of power can make conservation and environmental management more effective and just while also improving transdisciplinary research and practice.

Measuring Women Empowerment in Aquaculture – An Empirical Study

Development of index or tool for measuring social parameters has been a key area of research. This research was carried out during the year 2021 for the measurement and quantification of several variables warrants availability of valid tools. In aquaculture sector, gender mainstreaming efforts has been undertaken by several stakeholders. However, measuring the level of empowerment as a consequence of interventions could not be done in absence of such tools. The article describes the process of development of Women Empowerment in Aquaculture Index (WEAI) - selection of domains, assessing content validity through expert rating, screening of the domains using ‘t’ value and assigning relative weights. The instrument, so developed, has 30 items under 6 domains (access to and control over resources and services, ability to decide independently, attitude towards aquaculture, control over use of income, knowledge on aquaculture, participation in social and economic activities). Using the index, comparison was made between three women SHGs from Odisha with level of empowerment varying between 69-80 per cent.

Diagnostic Assessment of Post-COVID-19 Operations for Business Model Reconfiguration Decision

The current study develops a diagnostics assessment model of post-COVID-19 operations for business model reconfiguration decision referred to as the Pakade model. For this purpose, it identified seven diagnostic factors namely business operations disruptions, loss of human resources, changing cost structure due to safety requirements, work structure and culture change, disruption of supply chain and logistics, changing customer requirement and behaviour, and consequences of interventions on sustainability. The assessment was conducted using a 29-item scale scored on a 7-point scale representing the level of impact on the respective firm’s business model. The proposed model assesses the composite score and relative importance index for each business factor, highlights the approach for investigating the validity and reliability of this multidimensional model, and makes short- and long-term impact evaluation with multiple linear regression and difference-in-difference (DiD) method, respectively. Diagnostics assessment determines the form and extent of business model reconfiguration. It can either be an adjustment driven by the introduction or enhancement of world class work practices, a business re-engineering, or a complete change of the business model. This model can be applied to both the primary and secondary economic sectors to determine the changes required in the business model of a firm.

In situ treatment of juvenile frogs for disease can reverse population declines

AbstractEffective management of wildlife populations threatened by disease requires accurate predictions about the consequences of intervention. However, generating such predictions is challenging, especially for organisms with complex life histories that are also threatened by climate change, such as montane amphibians. Cascades frogs (Rana cascadae) in northern California have experienced dramatic declines associated with the fungal pathogen Batrachochytrium dendrobatidis (Bd), and remnant populations are also threatened by changing climate conditions. We evaluated the population‐level impacts of treating Cascades frog metamorphs with the antifungal chemical itraconazole using a field experiment and population simulations. We explored the influence of larval habitat on these treatment effects by including metamorphs from different larval habitat types. We found that frogs treated with itraconazole were more than four times more likely to survive their first winter than untreated controls and had reduced Bd infection intensity compared to other surviving frogs from the same cohort in the following year. We also found an effect of larval habitat type on Bd infection in recently metamorphosed frogs, with the lowest levels of infection occurring in frogs emerging from larval habitats that tend to be intermediate in temperature and drying rate. Applying the differential apparent overwinter survival of treated and untreated metamorphs to population projections suggests that intermittent antifungal treatment of metamorphs has the potential to restore population viability. Our results indicate that in situ treatment of individual hosts may be a useful component of a comprehensive management strategy to reduce the risk of pathogen‐mediated population declines and extirpations.

Responding to the deteriorating patient: The rationale for treatment escalation plans.

A Treatment Escalation Plan (TEP) is a communication tool designed to improve quality of care in hospital, particularly if patients deteriorate. The aims are to reduce variation caused by discontinuity of care; avoid harms caused by inappropriate treatment and promote patients' priorities and preferences. The TEP is based on the goals of treatment - 'What are we trying to achieve?' The goals take account of the context of acute illness, the consequences of interventions and discussion with the patient. They should reflect a shift away from 'fix-it' medicine to what is realistic and pragmatic. A TEP has three escalation categories: full escalation, selected appropriate treatments and palliative/supportive care. Other appropriate/inappropriate treatments are also recorded. Treatment Escalation Plans are associated with significant reductions in intensive care unit (ICU) admissions, non-beneficial interventions, harms and complaints. Treatment Escalation Plans contribute to staff well-being by reducing uncertainty. Successful implementation requires training and education in medical decision-making and communication skills.

Vitamin D: Before, during and after Pregnancy: Effect on Neonates and Children.

A worldwide high prevalence of vitamin D (VD) deficiency has become of growing concern because of potential adverse effects on human health, including pregnant women and their offsprings. Beyond its classical function as a regulator of calcium and phosphate metabolism, together with its fundamental role in bone health in every stage of life, its deficiency has been associated to multiple adverse health effects. The classic effects of VD deficiency in pregnancy and neonates have been late hypocalcemia and nutritional rickets. Nevertheless, recent studies have linked VD to fertility and 25(OH)D with several clinical conditions in pregnancy: preeclampsia, gestational diabetes, higher incidence of cesarean section and preterm birth, while in infants, the clinical conditions are low birth weight, lower bone mass and possible relationship with the development of such diseases as bronchiolitis, asthma, type 1 diabetes, multiple sclerosis and autism included as VD non-classical actions. The supplementation with Vitamin D and achievement of optimal levels reduce maternal-fetal and newborn complications. Supplementation in children with VD deficiency reduces the risk of respiratory infections and possibly autoimmune diseases and autism. This review emphasizes the roles of Vitamin D deficiency and the consequences of intervention from preconception to infancy.

Unwanted daughters: the unintended consequences of a ban on sex-selective abortions on the educational attainment of women

We study whether legal restrictions on prenatal discrimination against females leads to a shift by parents towards postnatal discrimination, focusing on the impact on educational attainment. We exploit the differentially timed introduction of a ban on sex-selective abortions across states in India. We find that a legal restriction on abortions led to an increase in the number of females born, as well as a widening in the gender gap in educational attainment. Females born in states affected by the ban are 2.3, 3.5, and 3.2 percentage points less likely to complete grade 10, complete grade 12, and enter university, respectively, relative to males. These effects are concentrated among non-wealthy households that lacked the resources to evade the ban. Investigating mechanisms, we find that the relative reduction in investments in female education was not driven by family size but because surviving females became relatively unwanted, whereas surviving males became relatively more valued, leading to an increasing concentration of household resources on them. Discrimination is amplified among higher-order births and among females with relatively few sisters. Finally, these negative effects exist despite the existence of a marriage market channel through which parents increase investments in their daughters’ education to increase the probability that they make a high-quality match. This suggests that policymakers need to address the unintended welfare consequences of interventions aimed at promoting gender equity.

What Can Be Done to Change?—The Environmental and Behavioral Consequences of Interventions for Sustainable Travel

We organized this Special Issue on “The Environmental and Behavioral Consequences of Interventions for Sustainable Travel” with the aim of attracting interdisciplinary perspectives on the environmental and behavioral consequences of different interventions for sustainable travel [...]

Machine assistance in energy-efficient building design: A predictive framework toward dynamic interaction with human decision-making under uncertainty

At the energy-efficient buildings design stage, architects suffer from multi-discipline requirements and insufficient information to make proper decisions during the process. Inspired by the human nervous system's estimation mechanism, we proposed a data-driven process-based framework for decision-making support. This framework achieves the performance-oriented decision aid under uncertainties based on a general component design, consisting of three parts: the probabilistic surrogate modeling, ensemble modeling, and the model interpretation method. With the characterization of uncertainties into aleatory or epistemic based on the possibility for minimization, the component’s design enables the framework to achieve dynamic interaction with users and inference toward higher intelligence to “make assumptions” in potential design space. Subsequently, it maps possible consequences of output scenarios to input variants’ causes by generating informative feedback and ensures a robust prediction under certain flexibility of incomplete inputs. We utilized the framework as an assistance system to conduct the strategic feedback of energy efficiency for building designers in different early design stages: The framework is tested on the Energy Performance Certificate (EPC) data from England and Wales (19,725,379 buildings). The result achieves a comparable forecasting performance as the SOTA machine learning and provides coherent input variants' interpretation. More importantly, during the design process, the framework enables to interactively provide building designers with expected building energy efficiency range in on-going possible design space with intervention consequences and input causes interpretation. Eventually, it drives users to operate toward higher energy-efficient building designs.

Health consequences of child removal among Indigenous and non-Indigenous sex workers: Examining trajectories, mechanisms and resiliencies.

The child protection system can be a highly consequential institution for mothers who are sex workers, yet scant attention has been paid to the health consequences of its policies on this population. Drawing on 31 in-depth, semi-structured interviews with 19 Indigenous and 12 non-Indigenous sex workers in Vancouver, Canada, and using the stress process model and the concept of slow violence, this study proposes a typology of four trajectories through which child removal by this system shaped sex workers' health. Results suggest that child removal has health consequences beyond the conventionally thought of mechanism of mental distress and related health sequelae, to additionally alter women's social conditions, which also carried risks for health. Notably, while trajectories of Indigenous and non-Indigenous sex workers were similar, Indigenous participants, whose families are disproportionately impacted by long-standing colonial policies of child removal, were more severely jeopardized. Findings highlight how child removal can enact violence in the form of reverberating harms to sex workers' health, further reinforcing their marginalized statuses. This study calls for greater attention to how the child protection system (CPS) may influence the health of marginalized mothers, including how health inequities may be both causes and consequences of interventions by this system.

Hypoxemia During One-Lung Ventilation: Does It Really Matter?

Purpose of ReviewHypoxemia during one-lung ventilation, while decreasing in frequency, persists as an intraoperative challenge for anesthesiologists. Discerning when desaturation and resultant hypoxemia correlates to tissue hypoxia is challenging in the perioperative setting and requires a thorough understanding of the physiology of oxygen delivery and tissue utilization.Recent FindingsOxygen delivery is not directly correlated with peripheral oxygen saturation in patients undergoing one-lung ventilation, emphasizing the importance of hemoglobin concentration and cardiac output in avoiding tissue hypoxia. While healthy humans can tolerate acute hypoxemia without long-term consequences, there is a paucity of evidence from patients undergoing thoracic surgery. Increasingly recognized is the potential harm of hyperoxic states, particularly in the setting of complex patients with comorbid diseases.SummaryAnesthesiologists are left to determine an acceptable oxygen saturation nadir that is individualized to the patient and procedure based on an understanding of oxygen supply, demand, and the consequences of interventions.

An exploratory qualitative study of undergraduate men’s perspectives on sexual violence bystander education

Objective This study examined the experiences of men in sexual violence bystander education programs at one institution of higher education. Participants: Twenty-three men participated in the study, of which 15 identified as men of color. Methods: Four focus groups were conducted, transcribed, and analyzed in Dedoose 8.2.14 using thematic analysis. Results: Many men questioned the applicability of national rates of sexual assault to their local campus. While bystander programing helped the men learn and use intervention skills, they critiqued these programs for unfairly characterizing all/most men as perpetrators. Additionally, Black men felt that the programing did not take into account potentially negative consequences of intervention for men of color. Conclusions: Presenting national statistics on sexual assault during bystander intervention programing may not increase men’s threat perception if not paired with local campus data. Future programing should consider addressing the complicated nature of intervention specifically for men of color.

Misaligned environmental governance indicators and the mismatch between government actions and positive environmental outcomes

The state of the environment continues declining despite improved global responses towards environmental protection. This mismatch could be because government policymakers and bureaucrats tend to focus on the tangible and controllable aspects of interventions – such as resources and actions – rather than the consequences of these interventions. We test this assumption by classifying governance indicators in the environmental sector according to a logic model: an evidence-based causal chain articulating the causes, effects and consequences of management interventions. In this paper, we synthesized consensus on logic models and developed a decision tree to classify governance indicators depending on whether they measured inputs, activities, outputs, outcomes and impacts. We then applied this decision tree to indicators from the South African government’s national environmental outcomes delivery agreement and found that environmental governance indicators tended to be at the activity or output levels. The shortage of indicators at the outcome level may explain why the state of the environment continues declining despite the environmental sector consistently meeting governance targets. Inappropriately aligned environmental governance indicators mean that officials work on interventions without knowing whether these are effective or not. Therefore, the environmental sector should prioritise the monitoring of the effectiveness of government interventions, rather than the interventions themselves.

Applying a Systems Perspective to Preventive Health: How Can It Be Useful? Comment on "What Can Policy-Makers Get Out of Systems Thinking? Policy Partners' Experiences of a Systems-Focused Research Collaboration in Preventive Health".

Advocates suggest that a paradigm shift in preventive health towards systems thinking is desirable and may be underway. In a recent study of policy-makers’ opinions, Haynes and colleagues found a mixed response to an Australian initiative that sought to apply systems theories and associated methods to preventive health. Some were enthusiastic about systems, but others were concerned or unconvinced about its usefulness. This commentary responds to such concerns. We argue that a systems perspective can help provide policy-makers with timely evidence to inform decisions about intervention planning and delivery. We also suggest that research applying a systems perspective could provide policy-makers with evidence to support planning and incremental decision-making; make recommendations to support intervention adaptability; consider potential barriers due to incoherent systems, and consider the political consequences of interventions.

A systematic review of prevention and treatment of infant behavioural sleep problems.

The aim of this review was to evaluate the evidence for interventions for behavioural sleep problem in infants. Systematic review based on a search in MEDLINE, Web of Science and PsychINFO in December 2017 for articles published in English during 2007-2017 about preventive and treatment interventions for sleep problems in infants. The review included controlled trials and meta-analyses with at least 20 infants in study groups assessed according to the Grading of Recommendations Assessment, Development and Evaluation criteria. Out of 476 original articles assessed for eligibility, 12 studies were included in the synthesis. Interventions with behavioural, educational and massage strategies were evaluated. No intervention was evaluated in more than one trial. Five interventions with behavioural methods for establishing consistent routines or controlled crying showed modest short-term effects, while the evidence for elements of education was inconsistent. Studies of massage were of poor quality. Knowledge gaps were identified regarding interventions in cross-cultural context, involving fathers, in children below six months of age, in high-risk populations and consequences of interventions that include extinction. Some support for short-term effects of behavioural treatment strategies was found, but more studies are needed to establish evidence.

Perspectives of patients, carers and mental health staff on early warning signs of relapse in psychosis: a qualitative investigation.

Relapse prevention strategies based on monitoring of early warning signs (EWS) are advocated for the management of psychosis. However, there has been a lack of research exploring how staff, carers and patients make sense of the utility of EWS, or how these are implemented in context. To develop a multiperspective theory of how EWS are understood and used, which is grounded in the experiences of mental health staff, carers and patients. Twenty-five focus groups were held across Glasgow and Melbourne (EMPOWER Trial, ISRCTN: 99559262). Participants comprised 88 mental health staff, 21 patients and 40 carers from UK and Australia (total n = 149). Data were analysed using constructivist grounded theory. All participants appeared to recognise EWS and acknowledged the importance of responding to EWS to support relapse prevention. However, recognition of and acting on EWS were constructed in a context of uncertainty, which appeared linked to risk appraisals that were dependent on distinct stakeholder roles and experiences. Within current relapse management, a process of weighted decision-making (where one factor was seen as more important than others) described how stakeholders weighed up the risks and consequences of relapse alongside the risks and consequences of intervention and help-seeking. Mental health staff, carers and patients speak about using EWS within a weighted decision-making process, which is acted out in the context of relationships that exist in current relapse management, rather than an objective response to specific signs and symptoms.